Sex Workers, Stigma and Self-Image: Evidence from Kolkata Brothels

Self-worth training can support marginalised people to escape pschological aspects of the poverty trap, and needs to be considered alongside material aspects when designing programmes to alleviate poverty.

Research Findings

This research study shows how empowering discriminated groups can help them overcome the poverty trap. Considerable research has looked at the material aspects of poverty (which includes access to banks, healthcare etc), but alongside this there is also a psychological poverty trap, which is internalised as an outcome of material poverty, of belonging to a lower caste and social exclusion. A strategy needs to incorporate both aspects to alleviate the poverty trap.

This research looks at sex workers in Kolkata, as these are members of a very  marginalised social group. Due to local perceptions that they’re doing immoral and ‘dirty work’, psychological constraints are very high amongst this community. These ideas aggravate poverty, and the marginalisation minimises material access. Most workers are also women, and so on top of the marginalisation they also experience levels of gender discrimination.

The hypothesis of this research was that if these mental constraints are relaxed, then behaviour and life choices may be changes. Mental constraints can be relaxed by exposure to cognitive behavioural therapy (CBT) that’s strongly focused on building self-image and self-worth. And this was proven true.

This study compared a group of sex workers from 98 brothels who went through self-image building CBT training with a control group. At the beginning both groups had rock-bottom levels of self-worth and had internalised that they did not deserve dignity. However, for the group who went to the two-months workshops, aimed at building self-worth and reframing their role as ‘entertainment workers’ amongst other things, significant changes were observed.

Many of the training group started making choices that benefitted their future. This was measured by them being significantly more likely to choose a fixed deposit (with higher returns in the long-term) than cash (more likely chosen by control group). Additionally, those who underwent training were more likely (by 10%) to visit a clinic for an additional preventive checkup, than those who didn’t do training. These indicators show higher levels of empowerment amongst those who took the self-worth training – and upto 21 months later, it was observed that retention was high. Those who did training had a higher savings account balances 15 months later than those who did not.

Key Recommendations

When creating new and innovative poverty alleviation programmes, states should consider psychological self-worth training in tandem to traditional and material poverty alleviation strategies, such as skilling and cash transfers. Begin with material, but add a psychological dimension.

Training workshops are a powerful tool to empower marginalised groups. Workshops should focus on changing a participants mindset towards “I can change my outcome and deserve a decent life”.

Health clinics can use this strategy as a way to encourage at-risk sex workers to increase their visits.

Implementation Examples

This research provides relevant insights for sex workers in any country.

This research can also be applied to any marginalised group in the developing world. These groups may be marginalised due to low caste, gender, race etc.

Methodology

Research used a randomised trail methodology. Brothels were randomly selected and exposed to the training programme. The question to be answered was do people exposed to training make different decisions afterwards that benefit them in the long run?

Groups were chosen by brothels rather than by individual. This was because pilot estimates showed that women within brothels interact with each other, but it is rare to see inter-brothel social interactions. 66 brothels were selected for the training group and 32 brothels were in the control group.

While it was a quantitative study, qualitative research offered context and layering.

Limitations

A one-size fits all solution does not exist.

While this study shows the importance of adopting psychological strategies for poverty alleviation, the material aspect cannot be ignored. Instead they should be paired together and considered in tandum.